CCM CCM Financial & Benefits Navigation 3

Question 1

The Social Security Disability Insurance (SSDI) program provides benefits to individuals who:

Accepted Answer

Have a qualifying disability and a sufficient work history of Social Security contributions

Answer

Are aged 65 or older

Answer

Are low-income regardless of work history

Answer

Are veterans with service-connected injuries

Question 2

Supplemental Security Income (SSI) differs from SSDI in that SSI is:

Accepted Answer

A needs-based program for disabled or elderly individuals with limited income and resources regardless of work history

Answer

Based on work history and Social Security credits

Answer

Only available to veterans

Answer

Funded entirely by state governments

Question 3

A case manager helping a client understand their 'out-of-pocket maximum' should explain that once this limit is reached:

Accepted Answer

The insurance plan pays 100% of covered services for the remainder of the benefit year

Answer

The client must pay all additional costs for the year

Answer

The client must re-enroll in a new plan

Answer

Only hospital services are covered at 100%

Question 4

Which resource connects patients to federally funded community health centers that provide care on a sliding-fee scale?

Accepted Answer

Federally Qualified Health Centers (FQHCs)

Answer

VA Medical Centers

Answer

Accountable Care Organizations (ACOs)

Answer

Medicare Advantage plans

Question 5

When a client is at risk of losing insurance coverage due to a lapse in premium payment, the case manager should first:

Accepted Answer

Check if the plan has a grace period and connect the client to financial assistance or premium subsidy programs

Answer

Advise the client to apply for a new plan immediately

Answer

Recommend the client visit an emergency room for immediate care needs

Answer

Close the case management record

Question 6

A client discharged from the hospital without insurance asks about immediate options for affordable prescription access. The BEST case manager response is to:

Accepted Answer

Refer to manufacturer patient assistance programs, GoodRx, or FQHC pharmacy services

Answer

Advise the client to use the emergency room for prescriptions

Answer

Tell the client to wait until open enrollment to obtain coverage

Answer

Recommend purchasing a full-price prescription plan online